Provider Demographics
NPI:1164786653
Name:RINALDI, JACLYN ANNETTE
Entity Type:Individual
Prefix:MS
First Name:JACLYN
Middle Name:ANNETTE
Last Name:RINALDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MARLIN DR
Mailing Address - Street 2:
Mailing Address - City:COPIAGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11726-5308
Mailing Address - Country:US
Mailing Address - Phone:516-810-7422
Mailing Address - Fax:631-532-5215
Practice Address - Street 1:11 MARLIN DR
Practice Address - Street 2:
Practice Address - City:COPIAGUE
Practice Address - State:NY
Practice Address - Zip Code:11726-5308
Practice Address - Country:US
Practice Address - Phone:516-810-7422
Practice Address - Fax:631-532-5215
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist